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  • 4th April 2016 | By David Jolley

    Where are we now? 

    How did we get here?

    How will we move on?

    You would think it is easy to know where we are and the journey which brought us to this time and space.

    Reminiscing during the week, a social science colleague reflected on the poverty of thought amongst present day psychiatrist and remembered with affection and awe, conversations with clinical phenomenologists of the past. 

    Manchester was the centre of phenomenological psychiatry during the late 1960s and into the 1970s. Working from the small unit housed in the Manchester home of Elizabeth Gaskell, Professor Anderson and his colleague Dr John Hoenig championed the approach based in the works of Karl Jaspers and others from the University of Heidelberg http://www.britannica.com/biography/Karl-Jaspers

    Anderson had retired and given way to Neil Kessel, and Hoenig had just departed for Canada when I came to Manchester 1970 as a trainee. Their teaching and tradition lingered on and was inspirational in the depth and value we discovered in listening to patients’ experiences as we sought to understand them as a first requirement to providing help.

    The hierarchy of values placed clinical activity and expertise at the pinnacle, to be supported by teaching and research. Somehow, somewhere in the intervening years, despite the massive increase in funding and the number of professionals working in mental health, this order of values has been changed and respect for individual experiences given less weight.

    Understanding the present and future from the past can be helped by mapping and I have enjoyed and recommend the series of historical maps produced by Alan Godfrey of Gateshead: http://www.alangodfreymaps.co.uk/. Whether it is to review the places where you have lived, or to learn more about a new work territory or holiday destination, these humble gems bring added depth to every street walk.

    I am led somewhere new by a recommendation from our first ‘Conversations’ at Bowdon Vale: ‘Words for a journey’ from Takashi Iba and Makoto Okada. Takashi Iba is a management guru who writes and researches patterns in words and other systems http://web.sfc.keio.ac.jp/~iba/.

    How he has come to apply his philosophy to living with dementia and related disorders is a new area of exploration for me.

    Heidelberg, Manchester, Gateshead, Keio – Listening and learning

     

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    Hopeful 29 March 2016 | Comments (0)

    28th March 2016 | By David Jolley

    Monday saw me complete my last ever clinical work as a registered medical practitioner – 47 years on from qualification via Guy’s Hospital Medical School in the University of London: MRCS (Eng), LRCP (London) and to take up my first post as House Physician at St Mary’s Hospital on the Isle of Wight. We have much to thank the Beatles for and I was not for waiting until the age of 64 before taking up temporary residence.

    It has been a huge privilege and I will write it down.

    The last clinic was beautiful – with one person seen with her daughter at the clinic base and five seen at home, all but one with a family member being present. So I saw the people, learned of their lives and current difficulties, felt their homes and knew their locality. One of the warmest hugs of the day was for the A-Z of Greater Manchester. What a friend you have been.

    Tuesday gave time with Ros Watson to reflect on our first session of Dementia Conversations and to look at where this has pointed us. It is important to keep listening and to remain flexible but we want also to make best use of the steers which came from that first session: Sharing experiences, gathering and sharing information, obtaining training, considering carers, perhaps adding to the range of activities which are inclusive of people with dementia, looking at the practicalities of appointing Admiral Nurses.

    But people also identified BIG AREAS: Primary Health Care, General Hospitals and Faith Communities, where we might begin to review local realities and make contributions to improve matters.

    Primary Care and Faith Communities are perhaps the closest to us and there are things we might do without too much delay. Work is afoot. Excitingly the potential of the Dementia Roadmap to help us in Primary Care is there for the taking. So one component of Pathfinders is already finding a niche within another. If we can make this work – we might help others to use a similar approach. Only 17 CCGs currently using the Roadmap: people with dementia in another 194 might benefit.

    Wednesday was a dream as we celebrated Easter on John Leigh Park with the pupils, staff and PTA of Altrincham Church of England School. We had a total school Easter Bonnet Parade – every hat sponsored to make a donation to the Marie Curie Foundation: daffodils on the park will always bring back the knowledge of cancer and the work of the Foundation – Ladies dressed in yellow came and charmed us and shared their knowledge and commitment.

    We shared joy at the facilities of the park as the pupils paraded in their bonnets and they swarmed to park to hunt for Easter Eggs – everyone was successful.

    The expert horticulturalist from the council reassured us that the daffodils we had hoped would be in bloom for this day will be in bloom for next and subsequent years: ‘They are shy and sulk for the first year at the insult of transfer and new planting.’ They are the native bulbs which Wordsworth so enjoyed and wrote of: www.poetryfoundation.org/poem/174790

    We are in this for the long game :)

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    Hoping 22 March 2016 | Comments (0)

    21st March 2016 | By David Jolley

    We are having an Easter Bonnet walk in the park on Wednesday with children from the local school sporting sponsored hats – Sponsorship for the Marie Curie Foundation. This is to rekindle a relation between the school, park and Marie Curie Foundation which began 20 years ago when the mother of children at the school became terminally ill.

    A Field of Hope – thousands of daffodils – was planted and bloomed magnificently for a few years but has latterly waned. We want to see hope re-established and sustained into the future.

    We planted 2000 daffodil bulbs in the autumn, 1000, snowdrops and 1000 bluebells. The yield is disappointingly sparse. Maybe we chose the wrong part of the park, maybe the very wet season has drowned the bulbs.

    Nothing to be done though other than to press on – We can celebrate Spring and what daffodils we have this year and photographs of the most successful years. We will wear hats and make a donation to Marie Curie and learn something from them about cancer and their work. We will be thankful for new picnic benches and hear something about the history and natural history of the park from a local expert. We will walk the park together and talk of realities and hopes.

    Perhaps there is more to be learned about hope and coming to terms with the wonders and frailties of biological systems, including human beings, when things do not go quite as we wish. Living with bad news and finding a new way will see us through.

    We are wanting to learn more about The Dementia Roadmap. Salford is nearby and has one and has a good reputation in dementia services. Their Roadmap is fronted by a scene featuring a tram! Perhaps there is less flexibility in Salford than the A-Z might suggest.

    It seems such a good idea – but who does what and how are the maps actually used? Can we see evaluations? Why are there only 17 maps registered to date?

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    14th March 2016 | By David Jolley

    Tuesday was our first outing under the Conversations banner of Dementia Pathfinders. We had the use of Bowdon Vale Methodist Church schoolroom and the warm hosting of the chapel, their stewards Jane and Sarah, and the committed involvement of the Reverend Ros Watson. Cakes and liquid refreshment (tea, coffee – Fairtrade – with and without caffeine, and juice). Balloons to mark the way – including blue, red and green as in the Pathfinders Logo. Car parking arranged.

    Phew – Can we play a CD? No problem.

    Who will come? There have been emails, telephone calls and words of mouth - but will anyone come? Maybe there will be more than we have room and refreshments for.

    Keep Calm – This is important but DON’T PANIC

    The leading article in the current Bowdon Church newsletter is headed: ‘Are you listening to me?’ Catherine Cleghorn, the Ordinand, shared her pleasure at being in receipt of careful listening from a friend: ‘something that I certainly don’t experience all the time’. This gave us a firm and apposite steer to have confidence to offer people time and space to share their thoughts, take them back and rearrange them; to use the time and company to be fearlessly creative.

    A quote from the previous Minister at the humbly located Bowdon Vale Chapel took us further down that road (or path!): ‘reaching into the community, seeking to fill the gaps which remain between elements of existing provision: fill a gap where nothing is provided – ‘Mind the gaps’

    Those of us who have travelled by tube recognise the refrain – It is good to find how helpful it is in this different context.

    We had a lovely afternoon of talk and thought. We have listed things which are sound and identified areas of uncertainty and weakness and will look at these carefully and plan actions.

    Today is warm and we have sunshine. How strengthening the change is as we emerge from so many days of cold and wet. How extraordinary that the crocuses can shake off the damp and stand so proud and radiant to such a short timescale.

    Walking with Tilly our Whippet, I lingered to look up at a knobbled old tree bathed in sunshine. Pleased enough to dwell on the shapes, colours and shadows, I was given more as a Nuthatch worried about in search of insects under the bark. She had not made a sound. I might have missed her if I had been walking at pace.

    My wife says that this is a lesson in living.
     

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